Perioperative blood transfusion in combat casualties: a pilot study.

Dunne JR, Hawksworth JS, Stojadinovic A, et al.
J Trauma 2009;66(4 Suppl):S150-156.
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Dunne and colleagues report an impaired wound healing rate, higher ICU admission rate, higher perioperative infection rate and longer hospital stay (statistically significant differences for all variables) in severely injured patients (combat casualties, 2 groups of 10 patients each) who received > 4 units of blood at hospital admission.

The data of this “pilot study” are interesting but have to be interpreted carefully at this stage of the entire study process. The pilot study is underpowered (n = 10 per study group!) for the conclusions drawn by the authors. The transfusion protocol applied is not specified. The relation between transfusion and inflammation in this extremely complex clinical situation is very difficult to determine. We are looking forward to the final results of the entire study and the necessary multivariate statistical analysis.

– Oliver Habler